Helping Spinal Cord Injury Victims Regain Balance

A new study has found that patients suffering from spinal cord injuries may regain lost balance through the electrical stimulation of toe muscles.

Researchers at the University of Toronto (Canada) examined ten able-bodied subjects who were asked to stand still on force plates. The flexor digitorum brevis and the flexor hallucis brevis muscles in the toes of both legs were simultaneously stimulated using a transcutaneous functional electrical stimulation (FES) device. The muscles were stimulated 20 times at random intervals with four different stimulation intensities to investigate if the FES would evoke center of pressure (COP) displacement that would result in corresponding body acceleration.

The researchers found that as expected, a larger stimulation induced a larger COP movement and acceleration, and therefore proposed the use of FES-induced contractions of the toe muscles as a means to control balance during FES-assisted quiet standing. The researchers claim that spinal cord-injured and severe-stroke patients could benefit from this electrical stimulation technique for improving FES-assisted standing. The study was published ahead of print in the online version of Artificial Organs.

"The toe stimulation could provide the torque and fine-control regulation necessary to allow patients to maintain their balance,” said lead author Dr. Kei Masani, Ph.D., of the rehabilitation-engineering laboratory. "In the near future, this would allow patients to stand without having to use their arms to maintain balance, allowing them to perform various activities of daily living while standing.”

Various devices have been developed to help patients with spinal cord injuries and severe stroke to stand in the initial months following the injury, until they can recover the ability to sit up, stand, and balance. These include surgically implanted FES systems, standing frames, and orthosis braces. However, it is very difficult for such devices to maintain the patients' balance.


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